Fibromyalgia – Cutting Through the B.S.

In our first episode in the Cutting Through the B.S. series we will tackle Fibromyalgia.  We discuss the different causes of this very confusing conditions as well as the many different treatment options that are out there and why many of them fail.  We will then further delve into what is causing the condition in many patients and treatment options we have found to work in our clinic.  Enjoy.

For information on scheduling a consultation to see if you may be a candidate for our program visit http://powerhealthconsult.com

 

References:

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Palstam A, Larsson A, Löfgren M, Ernberg M, Bjersing J, Bileviciute-Ljungar I, Gerdle B, Kosek E, Mannerkorpi K.
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2. Differences in pain-related fear acquisition and generalization: an experimental study comparing patients with fibromyalgia and healthy controls.
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10. Risk factors for longer term psychological distress in well-functioning fibromyalgia patients: a prospective study into prognostic factors.
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11. Fibromyalgia and non-celiac gluten sensitivity: a description with remission of fibromyalgia.
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12. New diagnostic criteria for fibromyalgia: Here to stay?
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Reumatol Clin. 2015 Jul-Aug;11(4):210-4. doi: 10.1016/j.reuma.2014.07.008. Epub 2014 Oct 23. English, Spanish.
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13. [The association of fibromyalgia and systemic lupus erythematosus change the presentation and severity of both diseases?].
de Araújo AL, Paliares IC, de Araújo MI, Novo NF, Cadaval RA, Martinez JE.
Rev Bras Reumatol. 2015 Jan-Feb;55(1):37-42. doi: 10.1016/j.rbr.2014.08.004. Epub 2014 Oct 16. Portuguese.
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14. The gut microbiome and the brain.
Galland L.
J Med Food. 2014 Dec;17(12):1261-72. doi: 10.1089/jmf.2014.7000. Review.
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15. Cytokine and chemokine profiles in fibromyalgia, rheumatoid arthritis and systemic lupus erythematosus: a potentially useful tool in differential diagnosis.
Wallace DJ, Gavin IM, Karpenko O, Barkhordar F, Gillis BS.
Rheumatol Int. 2015 Jun;35(6):991-6. doi: 10.1007/s00296-014-3172-2. Epub 2014 Nov 7.
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16. The prevalence of fibromyalgia in the general population: a comparison of the American College of Rheumatology 1990, 2010, and modified 2010 classification criteria.
Jones GT, Atzeni F, Beasley M, Flüß E, Sarzi-Puttini P, Macfarlane GJ.
Arthritis Rheumatol. 2015 Feb;67(2):568-75. doi: 10.1002/art.38905.
PMID: 25323744 [PubMed – indexed for MEDLINE] Free Article
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17. Factors associated with tender point count in Puerto Ricans with fibromyalgia syndrome.
Ríos G, Estrada M, Mayor AM, Vilá LM.
P R Health Sci J. 2014 Sep;33(3):112-6.
PMID: 25244879 [PubMed – indexed for MEDLINE] Free PMC Article
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18. Transcranial magnetic stimulation for chronic pain.
Young NA, Sharma M, Deogaonkar M.
Neurosurg Clin N Am. 2014 Oct;25(4):819-32. doi: 10.1016/j.nec.2014.07.007. Epub 2014 Aug 12. Review.
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19. Microneurographic recording from unmyelinated nerve fibers in neurological disorders: an update.
Donadio V, Liguori R.
Clin Neurophysiol. 2015 Mar;126(3):437-45. doi: 10.1016/j.clinph.2014.10.009. Epub 2014 Oct 17. Review.
PMID: 25457652 [PubMed – indexed for MEDLINE]
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20. Reduction of Intraepidermal Nerve Fiber Density (IENFD) in the skin biopsies of patients with fibromyalgia: a controlled study.
Kosmidis ML, Koutsogeorgopoulou L, Alexopoulos H, Mamali I, Vlachoyiannopoulos PG, Voulgarelis M, Moutsopoulos HM, Tzioufas AG, Dalakas MC.
J Neurol Sci. 2014 Dec 15;347(1-2):143-7. doi: 10.1016/j.jns.2014.09.035. Epub 2014 Sep 28.
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21. Small nerve fiber involvement in patients referred for fibromyalgia.
Giannoccaro MP, Donadio V, Incensi A, Avoni P, Liguori R.
Muscle Nerve. 2014 May;49(5):757-9. doi: 10.1002/mus.24156. Epub 2014 Jan 28.
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22. Hyperexcitable C nociceptors in fibromyalgia.
Serra J, Collado A, Solà R, Antonelli F, Torres X, Salgueiro M, Quiles C, Bostock H.
Ann Neurol. 2014 Feb;75(2):196-208. doi: 10.1002/ana.24065. Epub 2014 Feb 12.
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23. Objective evidence that small-fiber polyneuropathy underlies some illnesses currently labeled as fibromyalgia.
Oaklander AL, Herzog ZD, Downs HM, Klein MM.
Pain. 2013 Nov;154(11):2310-6. doi: 10.1016/j.pain.2013.06.001. Epub 2013 Jun 5.
PMID: 23748113 [PubMed – indexed for MEDLINE] Free PMC Article
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24. Small fibre pathology in patients with fibromyalgia syndrome.
Üçeyler N, Zeller D, Kahn AK, Kewenig S, Kittel-Schneider S, Schmid A, Casanova-Molla J, Reiners K, Sommer C.
Brain. 2013 Jun;136(Pt 6):1857-67. doi: 10.1093/brain/awt053. Epub 2013 Mar 9.
PMID: 23474848 [PubMed – indexed for MEDLINE]
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25. Chronic pain as a manifestation of potassium channel-complex autoimmunity.
Klein CJ, Lennon VA, Aston PA, McKeon A, Pittock SJ.
Neurology. 2012 Sep 11;79(11):1136-44. doi: 10.1212/WNL.0b013e3182698cab. Epub 2012 Aug 15.
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26. Central sensitization in fibromyalgia? A systematic review on structural and functional brain MRI.
Cagnie B, Coppieters I, Denecker S, Six J, Danneels L, Meeus M.
Semin Arthritis Rheum. 2014 Aug;44(1):68-75. doi: 10.1016/j.semarthrit.2014.01.001. Epub 2014 Jan 8. Review.
PMID: 24508406 [PubMed – indexed for MEDLINE]
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27. Attentional bias toward negative information in patients with fibromyalgia syndrome.
Duschek S, Werner NS, Limbert N, Winkelmann A, Montoya P.
Pain Med. 2014 Apr;15(4):603-12. doi: 10.1111/pme.12360. Epub 2014 Jan 21.
PMID: 24447855 [PubMed – indexed for MEDLINE]
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28. Fibromyalgia and chronic widespread pain in autoimmune thyroid disease.
Ahmad J, Tagoe CE.
Clin Rheumatol. 2014 Jul;33(7):885-91. doi: 10.1007/s10067-014-2490-9. Epub 2014 Jan 18. Review.
PMID: 24435355 [PubMed – indexed for MEDLINE]
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29. Segmental hyperalgesia to mechanical stimulus in interstitial cystitis/bladder pain syndrome: evidence of central sensitization.
Lai HH, Gardner V, Ness TJ, Gereau RW 4th.
J Urol. 2014 May;191(5):1294-9. doi: 10.1016/j.juro.2013.11.099. Epub 2013 Dec 6.
PMID: 24316091 [PubMed – indexed for MEDLINE] Free PMC Article
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30. Structural alterations in brainstem of fibromyalgia syndrome patients correlate with sensitivity to mechanical pressure.
Fallon N, Alghamdi J, Chiu Y, Sluming V, Nurmikko T, Stancak A.
Neuroimage Clin. 2013 Aug 9;3:163-70. doi: 10.1016/j.nicl.2013.07.011. eCollection 2013.
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31. Clinical endocannabinoid deficiency (CECD) revisited: can this concept explain the therapeutic benefits of cannabis in migraine, fibromyalgia, irritable bowel syndrome and other treatment-resistant conditions?
Smith SC, Wagner MS.
Neuro Endocrinol Lett. 2014;35(3):198-201. Review.
PMID: 24977967 [PubMed – indexed for MEDLINE]
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32. A novel comparative effectiveness study of Tai Chi versus aerobic exercise for fibromyalgia: study protocol for a randomized controlled trial.
Wang C, McAlindon T, Fielding RA, Harvey WF, Driban JB, Price LL, Kalish R, Schmid A, Scott TM, Schmid CH.
Trials. 2015 Jan 30;16:34. doi: 10.1186/s13063-015-0548-x.
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33. Metals as a common trigger of inflammation resulting in non-specific symptoms: diagnosis and treatment.
Stejskal V.
Isr Med Assoc J. 2014 Dec;16(12):753-8.
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34. Disinhibition of the primary somatosensory cortex in patients with fibromyalgia.
Lim M, Roosink M, Kim JS, Kim DJ, Kim HW, Lee EB, Kim HA, Chung CK.
Pain. 2015 Apr;156(4):666-74. doi: 10.1097/j.pain.0000000000000096.
PMID: 25630027 [PubMed – indexed for MEDLINE]
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35. Mindfulness training for reducing anger, anxiety, and depression in fibromyalgia patients.
Amutio A, Franco C, Pérez-Fuentes Mde C, Gázquez JJ, Mercader I.
Front Psychol. 2015 Jan 12;5:1572. doi: 10.3389/fpsyg.2014.01572. eCollection 2014.
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36. Patterns of health care utilization related to initiation of amitriptyline, duloxetine, gabapentin, or pregabalin in fibromyalgia.
Kim SC, Landon JE, Lee YC.
Arthritis Res Ther. 2015 Jan 28;17:18. doi: 10.1186/s13075-015-0530-8.
PMID: 25627453 [PubMed – indexed for MEDLINE] Free PMC Article
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37. [Gait characteristics of women with fibromyalgia: a premature aging pattern].
Góes SM, Leite N, de Souza RM, Homann D, Osiecki AC, Stefanello JM, Rodacki AL.
Rev Bras Reumatol. 2014 Sep-Oct;54(5):335-41. doi: 10.1016/j.rbr.2013.11.003. Epub 2014 Jul 6. Portuguese.
PMID: 25627295 [PubMed – indexed for MEDLINE] Free Article
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38. [Characterization of the pain, sleep and alexithymia patterns of patients with fibromyalgia treated in a Brazilian tertiary center].
Avila LA, de Araujo Filho GM, Guimarães EF, Gonçalves LC, Paschoalin PN, Aleixo FB.
Rev Bras Reumatol. 2014 Sep-Oct;54(5):409-13. doi: 10.1016/j.rbr.2014.03.017. Epub 2014 Jul 6. Portuguese.
PMID: 25627308 [PubMed – indexed for MEDLINE] Free Article
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39. The somatosensory link in fibromyalgia: functional connectivity of the primary somatosensory cortex is altered by sustained pain and is associated with clinical/autonomic dysfunction.
Kim J, Loggia ML, Cahalan CM, Harris RE, Beissner F Dr Phil Nat, Garcia RG, Kim H, Wasan AD, Edwards RR, Napadow V.
Arthritis Rheumatol. 2015 May;67(5):1395-1405. doi: 10.1002/art.39043.
PMID: 25622796 [PubMed – indexed for MEDLINE] Free PMC Article
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40. Rheumatic symptoms in autoimmune thyroiditis.
Tagoe CE.
Curr Rheumatol Rep. 2015 Feb;17(2):5. doi: 10.1007/s11926-014-0479-7. Review.
PMID: 25618571 [PubMed – indexed for MEDLINE]
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41. Attenuation of autoimmune responses to oxidative specific epitopes, but not nitroso-adducts, is associated with a better clinical outcome in Myalgic Encephalomyelitis/chronic fatigue syndrome.
Maes M, Leunis JC.
Neuro Endocrinol Lett. 2014;35(7):577-85.
PMID: 25617880 [PubMed – indexed for MEDLINE]
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42. Evidence supporting a link between dental amalgams and chronic illness, fatigue, depression, anxiety, and suicide.
Kern JK, Geier DA, Bjørklund G, King PG, Homme KG, Haley BE, Sykes LK, Geier MR.
Neuro Endocrinol Lett. 2014;35(7):537-52. Review.
PMID: 25617876 [PubMed – indexed for MEDLINE]
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43. What has functional connectivity and chemical neuroimaging in fibromyalgia taught us about the mechanisms and management of ‘centralized’ pain?
Napadow V, Harris RE.
Arthritis Res Ther. 2014;16(5):425. Review.
PMID: 25606591 [PubMed – indexed for MEDLINE] Free PMC Article
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44. Gluten-free diet in the management of patients with irritable bowel syndrome, fibromyalgia and lymphocytic enteritis.
Volta U.
Arthritis Res Ther. 2014 Dec 23;16(6):505. doi: 10.1186/s13075-014-0505-1.
PMID: 25602179 [PubMed – indexed for MEDLINE] Free PMC Article
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45. Transcranial direct current stimulation as a treatment for patients with fibromyalgia: a randomized controlled trial.
Fagerlund AJ, Hansen OA, Aslaksen PM.
Pain. 2015 Jan;156(1):62-71. doi: 10.1016/j.pain.0000000000000006.
PMID: 25599302 [PubMed – indexed for MEDLINE]
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46. Soluble fractalkine in the plasma of fibromyalgia patients.
Garcia JJ, Ortega E.
An Acad Bras Cienc. 2014 Dec;86(4):1915-7. doi: 10.1590/0001-3765201420130081. Epub 2014 Dec 9.
PMID: 25590727 [PubMed – indexed for MEDLINE] Free Article
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47. Fibromyalgia Flares: A Qualitative Analysis.
Vincent A, Whipple MO, Rhudy LM.
Pain Med. 2016 Mar;17(3):463-468. Epub 2016 Mar 1.
PMID: 25586303 [PubMed – indexed for MEDLINE]
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48. Fibrofog and fibromyalgia: a narrative review and implications for clinical practice.
Kravitz HM, Katz RS.
Rheumatol Int. 2015 Jul;35(7):1115-25. doi: 10.1007/s00296-014-3208-7. Epub 2015 Jan 13. Review.
PMID: 25583051 [PubMed – indexed for MEDLINE]
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49. Clinical Value of Serum Neuroplasticity Mediators in Identifying the Central Sensitivity Syndrome in Patients With Chronic Pain With and Without Structural Pathology.
Deitos A, Dussán-Sarria JA, Souza Ad, Medeiros L, Tarragô Mda G, Sehn F, Chassot M, Zanette S, Schwertner A, Fregni F, Torres IL, Caumo W.
Clin J Pain. 2015 Nov;31(11):959-67. doi: 10.1097/AJP.0000000000000194.
PMID: 25551477 [PubMed – indexed for MEDLINE]
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50. Cognitive dysfunction in fibromyalgia: slow access to the mental lexicon.
Leavitt F, Katz RS.
Psychol Rep. 2014 Dec;115(3):828-39. doi: 10.2466/04.15.PR0.115c32z1.
PMID: 25539171 [PubMed – indexed for MEDLINE]
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51. The Role and Importance of Small Fiber Neuropathy in Fibromyalgia Pain.
Caro XJ, Winter EF.
Curr Pain Headache Rep. 2015 Dec;19(12):55. doi: 10.1007/s11916-015-0527-7. Review.
PMID: 26497568 [PubMed – indexed for MEDLINE]
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52. Differential dopamine function in fibromyalgia.
Albrecht DS, MacKie PJ, Kareken DA, Hutchins GD, Chumin EJ, Christian BT, Yoder KK.
Brain Imaging Behav. 2016 Sep;10(3):829-39. doi: 10.1007/s11682-015-9459-4.
PMID: 26497890 [PubMed – in process]
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53. Review of the Uses of Vagal Nerve Stimulation in Chronic Pain Management.
Chakravarthy K, Chaudhry H, Williams K, Christo PJ.
Curr Pain Headache Rep. 2015 Dec;19(12):54. doi: 10.1007/s11916-015-0528-6. Review.
PMID: 26493698 [PubMed – indexed for MEDLINE]
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54. The association of total and central body fat with pain, fatigue and the impact of fibromyalgia in women; role of physical fitness.
Segura-Jiménez V, Castro-Piñero J, Soriano-Maldonado A, Álvarez-Gallardo IC, Estévez-López F, Delgado-Fernández M, Carbonell-Baeza A; al-Ándalus project.
Eur J Pain. 2016 May;20(5):811-21. doi: 10.1002/ejp.807. Epub 2015 Oct 22.
PMID: 26492384 [PubMed – indexed for MEDLINE]
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55. Post-traumatic stress disorder symptoms may explain poor mental health in patients with fibromyalgia.
Toussaint LL, Whipple MO, Vincent A.
J Health Psychol. 2015 Oct 20. pii: 1359105315611957. [Epub ahead of print]
PMID: 26490627 [PubMed – as supplied by publisher]
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56. Fibromyalgia Syndrome – a multidisciplinary approach.
Binkiewicz-Gli?ska A, Baku?a S, Tomczak H, Landowski J, Ruckemann-Dziurdzi?ska K, Zaborowska-Sapeta K, Kowalski I, Kiebzak W.
Psychiatr Pol. 2015;49(4):801-10. doi: 10.12740/psychiatriapolska.pl/online-first/4. Review. English, Polish.
PMID: 26488355 [PubMed – indexed for MEDLINE] Free Article
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57. Increased cortical activation upon painful stimulation in fibromyalgia syndrome.
Üçeyler N, Zeller J, Kewenig S, Kittel-Schneider S, Fallgatter AJ, Sommer C.
BMC Neurol. 2015 Oct 20;15:210. doi: 10.1186/s12883-015-0472-4.
PMID: 26486985 [PubMed – indexed for MEDLINE] Free PMC Article
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58. “Clinical approach to fibromyalgia: Synthesis of Evidence-based recommendations, a systematic review”.
Ángel García D, Martínez Nicolás I, Saturno Hernández PJ.
Reumatol Clin. 2016 Mar-Apr;12(2):65-71. doi: 10.1016/j.reuma.2015.06.001. Epub 2015 Oct 16. Review. English, Spanish.
PMID: 26481494 [PubMed – indexed for MEDLINE] Free Article
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59. Neurocognitive complaints and functional status among patients with chronic fatigue syndrome and fibromyalgia.
Schmaling KB, Betterton KL.
Qual Life Res. 2016 May;25(5):1257-63. doi: 10.1007/s11136-015-1160-y. Epub 2015 Oct 15.
PMID: 26471263 [PubMed – indexed for MEDLINE]
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60. Ineffective ADL skills in women with fibromyalgia: a cross-sectional study.
Von Bülow C, Amris K, La Cour K, Danneskiold-Samsøe B, Wæhrens EE.
Scand J Occup Ther. 2016 Sep;23(5):391-7. doi: 10.3109/11038128.2015.1095237. Epub 2015 Oct 15.
PMID: 26468666 [PubMed – indexed for MEDLINE]
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61. Clinically Effective Treatment of Fibromyalgia Pain With High-Definition Transcranial Direct Current Stimulation: Phase II Open-Label Dose Optimization.
Castillo-Saavedra L, Gebodh N, Bikson M, Diaz-Cruz C, Brandao R, Coutinho L, Truong D, Datta A, Shani-Hershkovich R, Weiss M, Laufer I, Reches A, Peremen Z, Geva A, Parra LC, Fregni F.
J Pain. 2016 Jan;17(1):14-26. doi: 10.1016/j.jpain.2015.09.009. Epub 2015 Oct 9.
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62. A new case definition of Neuro-Inflammatory and Oxidative Fatigue (NIOF), a neuroprogressive disorder, formerly known as chronic fatigue syndrome or Myalgic Encephalomyelitis: results of multivariate pattern recognition methods and external validation by neuro-immune biomarkers.
Maes M.
Neuro Endocrinol Lett. 2015;36(4):320-9.
PMID: 26454487 [PubMed – indexed for MEDLINE]
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63. Fibromyalgia: A Critical and Comprehensive Review.
Borchers AT, Gershwin ME.
Clin Rev Allergy Immunol. 2015 Oct;49(2):100-51. doi: 10.1007/s12016-015-8509-4. Review.
PMID: 26445775 [PubMed – indexed for MEDLINE]
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64. Stress exacerbates pain in the everyday lives of women with fibromyalgia syndrome–The role of cortisol and alpha-amylase.
Fischer S, Doerr JM, Strahler J, Mewes R, Thieme K, Nater UM.
Psychoneuroendocrinology. 2016 Jan;63:68-77. doi: 10.1016/j.psyneuen.2015.09.018. Epub 2015 Sep 21.
PMID: 26431802 [PubMed – indexed for MEDLINE]
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65. Meta-analytic evidence for decreased heart rate variability in chronic pain implicating parasympathetic nervous system dysregulation.
Tracy LM, Ioannou L, Baker KS, Gibson SJ, Georgiou-Karistianis N, Giummarra MJ.
Pain. 2016 Jan;157(1):7-29. doi: 10.1097/j.pain.0000000000000360.
PMID: 26431423 [PubMed – indexed for MEDLINE]
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66. Is Serum Hypovitaminosis D Associated with Chronic Widespread Pain Including Fibromyalgia? A Meta-analysis of Observational Studies.
Hsiao MY, Hung CY, Chang KV, Han DS, Wang TG.
Pain Physician. 2015 Sep-Oct;18(5):E877-87. Review.
PMID: 26431141 [PubMed – indexed for MEDLINE] Free Article
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67. Normalization of aberrant resting state functional connectivity in fibromyalgia patients following a three month physical exercise therapy.
Flodin P, Martinsen S, Mannerkorpi K, Löfgren M, Bileviciute-Ljungar I, Kosek E, Fransson P.
Neuroimage Clin. 2015 Aug 18;9:134-9. doi: 10.1016/j.nicl.2015.08.004. eCollection 2015.
PMID: 26413476 [PubMed – indexed for MEDLINE] Free PMC Article
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68. Cortisol Profile Mediates the Relation Between Childhood Neglect and Pain and Emotional Symptoms among Patients with Fibromyalgia.
Yeung EW, Davis MC, Ciaramitaro MC.
Ann Behav Med. 2016 Feb;50(1):87-97. doi: 10.1007/s12160-015-9734-z.
PMID: 26404060 [PubMed – indexed for MEDLINE] Free PMC Article
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69. Potential drug therapies for the treatment of fibromyalgia.
Lawson K.
Expert Opin Investig Drugs. 2016 Sep;25(9):1071-81. doi: 10.1080/13543784.2016.1197906. Epub 2016 Jun 16. Review.
PMID: 27269389 [PubMed – indexed for MEDLINE]
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70. Gray matter abnormalities associated with fibromyalgia: A meta-analysis of voxel-based morphometric studies.
Shi H, Yuan C, Dai Z, Ma H, Sheng L.
Semin Arthritis Rheum. 2016 Dec;46(3):330-337. doi: 10.1016/j.semarthrit.2016.06.002. Epub 2016 Jun 8.
PMID: 27989500 [PubMed – in process]
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71. The social construction of fibromyalgia as a health problem from the perspective of policies, professionals, and patients.
Briones-Vozmediano E.
Glob Health Action. 2016 Dec 19;9:31967. doi: 10.3402/gha.v9.31967. eCollection 2016.
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72. Histological Underpinnings of Grey Matter Changes in Fibromyalgia Investigated Using Multimodal Brain Imaging.
Pomares FB, Funck T, Feier NA, Roy S, Daigle-Martel A, Ceko M, Narayanan S, Araujo D, Thiel A, Stikov N, Fitzcharles MA, Schweinhardt P.
J Neurosci. 2017 Feb 1;37(5):1090-1101. doi: 10.1523/JNEUROSCI.2619-16.2016. Epub 2016 Dec 16.
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3 Comments

  1. Finally – Thank you so much for the detailed explanation. My journey has been long and many, many different treatments for FMS. I was first diagnosed with RLS in 1987 (even though I had pain throughout my body). Iron deficiency, Vitamin B12 injections, Parkinson’s medications, Codeine, seizure medications….and on and on. I finally quit taking medications that did not help. My latest diagnosis, other than osteoarthritis, is Mild Cognitive Impairment which resulted in my retiring at 60 with Social Security Disability. Thank you – understanding is major for me.

  2. Thank You So Much for your Presentation! I didn’t know what else to do after being diagnosed by a Neurologist in 1997 I have been labeled a quack, and seeking attention and the latest conversion disorder. I hate going to Doctors and have been trying to find answers on my own. I feel vindicated just by having watched your presentation! How can I get help?

  3. The first step would be to have a consultation to see if you would be a good candidate for our program. You can find out more about how to do that here http://powerhealthconsult.com

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